The acting director of the troubled Hawaii State Hospital admitted Wednesday that he lacks the minimum educational qualifications to head the facility and was grilled about charges that managers manipulate the hiring process to unfairly hire some of their relatives.

Bill Elliott has been the acting administrator of the state's only public mental hospital for the last 13 months. Elliott spent 19 years as its associate director, dealing with non-clinical aspects of hospital operations like personnel, budgets and facilities.

"Are you in possession of a master's degree in nursing?" asked State Sen. Clayton Hee, co-chair of the Senate Special Investigative Committee on the Hawaii State Hospital.

"No sir," Elliott answered.

"Are you in possession of a master's degree in social work?" Hee asked.

"No sir," Elliott answered again.

Elliott admitted that he does not meet the minimum requirements to be administrator of the hospital, which require the administrator to be a medical doctor, have credentials in psychology or psychiatry or a master's degree in various related subjects.

Elliott told Hawaii News Now he has an undergraduate degree in business administration and has been doing both of the hospital's top jobs for more than a year.

"Not either one as good as I could have done separately, but I think I've done a reasonable job with holding down both positions and operating the hospital," Elliott told senators.

Senators then asked Elliott about what employees describe as "rampant nepotism" at the hospital and senators said seven managers have anywhere from three, four or five relatives each on the payroll.

"It's a situation of who you know as opposed to what you know when it comes to hiring at the Hawaii State Hospital," Hee said.

State Sen. Josh Green, co-chair of the special committee, himself an emergency room doctor, said,"I learned that there is a significant nepotism problem over at the State Hospital. I think that they need to get their house in order."

For instance, Nursing Director Leona Guest has a daughter, son and two nieces working at the hospital, all of whom were hired after she started working there, employees said.

When senators asked Elliott if Guest recused herself from influencing the hiring of her family members, he said, "I don't know the answer to that senator, I just don't. So I would have to refer to her."

Guest has been subpoenaed to testify before senators in the months ahead.

Asked if it's possible a nurse manager could have sat on a selection committee and helped hire a relative, Elliott said, "I suppose it's possible. Again, they are supposed to recuse themselves if they know individuals, and not participate."

When a senator asked him if he'd be surprised and disappointed if managers influenced the hiring of their relatives, Elliott said, "More and more I'm becoming less surprised about some of the things."

And Elliott said if a supervisor did not properly recuse themselves from hiring a relative, "I would find it to be wrong and I'd certainly look into it," investigating the charge and enforcing appropriate discipline, if the case could be proven.

When Hawaii News Now asked State Health Director Linda Rosen if there is a nepotism problem at the state hospital, she said, "I don't at this point, know. There is a potential for that. But I have not seen any documentation that there is nepotism or preferential treatment going on."

Elliott said he was not aware that several hospital managers had so many relatives on the staff until he and his staff compiled a list of employees for the senators as part of their investigation.

State hospital employees who've been injured by patient assaults on the job said nepotism affects patient and employee safety.

"And if you have aunties and uncles and whatnot carrying around as a family atmosphere, not a professional atmosphere, they're not the getting the care they deserve," said Kalford Keanu, a psychiatric technician who's been out of work for months after being attacked from behind by a mental patient two days after the same patient attacked another staffer.

Keanu and four other injured hospital employees sat in the front row of the hearing at the State Capitol.

"I'm sure heads will roll," said Green, when asked by Hawaii News Now after the hearing if he thinks people should lose their jobs over management problems at the hospital.

When Green was asked about Elliott holding down the top two jobs when he does not meet the minimum education requirements for the hospital administrator job, Green said, ""I think he's trying but I don't know of anybody that can have two full-time roles when the job is already at 200-percent capacity need to solve the problem. That was disturbing to me."

"Just because he's holding two jobs doesn't mean he's not performing adequately," said Rosen, who noted it's not uncommon for people to work as an acting administrator while still filling their old position while a search is underway for a replacement.

Rosen said the Health Department is "close" to hiring a permanent administrator. Elliott said he had applied for the permanent post and went through interviews for the job.

Elliot said the department has a 12-percent vacancy rate, with about 60 positions currently open. He said he meets every other week to get updates on unfilled positions from personnel staff.

Elliott said it takes more than 66 working days to fill an open position, because openings must be advertised, and then applicants tested and interviewed before a hiring committee makes a final recommendation to state personnel officials.